Learning about Breast Cancer
- Peggy Lynah, 95, was six weeks pregnant when she found a lump in her breast in 1965. Thankfully, she underwent a successful surgery and rehabbed her arm back to its original strength. She’s sharing her story today in the hopes that it will help others facing a similar issue.
- Breast cancer is a common cancer that has been the subject of much research, so there are many treatment options out there. Mammograms, a standard screening procedure for breast cancer, and self breast exams can save lives.
- Signs and symptoms of breast cancer can include a breast lump or thickening that feels different from the surrounding tissue; a change in the size, shape or appearance of a breast; changes to the skin over the breast such as dimpling; developing a newly inverted nipple; peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin; and redness or pitting of the skin over your breast like the skin of an orange.
- Risk factors for breast cancer include: being a woman, age, family history, having had a prior biopsy on an abnormal area, radiation exposure, lifetime estrogen exposure, not having a child before age 30 or never having children, obesity, drinking alcohol and lack of exercise.
Lynah was six weeks pregnant with her daughter, Ruthie Lynah Whitlow, when she discovered a lump in her left breast in 1965. That’s when she decided to call a family friend and surgeon.
Read MoreBut even still, Lynah had to deal with others doctors telling her she should abort her baby. Thankfully, a call to her uncle, who was a doctor, helped matters for the better.
"It was very, very unsettling," she said of the doctors trying to convince her to get an abortion. "When they left, I called my uncle who was a doctor. You can bet those doctors didn't come back to my room."
Her surgeon also instilled confidence in her and helped get her through her cancer journey.
"I had confidence in Dr. Quattlebaum and believed it when he told me that God would get me through it all," she said.
Fortunately, Lynah did not need further treatment beyond surgery, but she did regain the strength she had lost in her left arm. Physical therapy wasn’t much of a thing back then, so she rigged a pulley to her shower curtain that she used to exercise every day. Eventually, Lynah was able to work outside the home, play golf, go fishing and resume a normal life, and today she’s sharing her survivor story because her daughter thought it might inspire others.
"I've never talked about this because it's very private," Lynah said. “But she (pointing to daughter Ruthie Lynah Whitlow) thinks it might help just one person."
Understanding Breast Cancer
Breast cancer is a common cancer that has been the subject of much research. Many women develop this disease every year, but men can develop this cancer too though it is more rare, in part, due to the simple fact that they have less breast tissue.
There are many treatment options for people with this disease, but treatment depends greatly on the specifics of each case. Identifying these specifics means looking into whether the cancerous cells have certain receptors. These receptors the estrogen receptor, the progesterone receptor and the HER2 receptor can help identify the unique features of the cancer and help personalize treatment.
"These receptors, I like to imagine them like little hands on the outside of the cell, they can grab hold of what we call ligands, and these ligands are essentially the hormones that may be circulating in the bloodstream that can then be pulled into this cancer cell and used as a fertilizer, as growth support for the cells," Dr. Elizabeth Comen, a medical oncologist at Memorial Sloan Kettering Cancer Center, previously told SurvivorNet.
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One example of a type of ligand that can stimulate a cancer cell is the hormone estrogen, hence why an estrogen receptor positive breast cancer will grow when stimulated by estrogen. For these cases, your doctor may offer treatment that specifically targets the estrogen receptor. But for HER2 positive breast cancers, therapies that uniquely target the HER2 receptor may be the most beneficial.
Symptoms of Breast Cancer
Signs and symptoms of the disease can include the following:
- A breast lump or thickening that feels different from the surrounding tissue
- Change in the size, shape or appearance of a breast
- Changes to the skin over the breast, such as dimpling
- A newly inverted nipple
- Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
- Redness or pitting of the skin over your breast, like the skin of an orange
It's important to keep an eye out for these symptoms while remembering that having one or many of them does not necessarily mean you have breast cancer. Regardless, you should always speak with a doctor promptly if anything ever feels off or you're experiencing one or more of the signs listed above. You never know when speaking up about your health can lead to a very important diagnosis.
Breast Cancer Screening
Screening for breast cancer is typically done via mammogram, which looks for lumps in the breast tissue and signs of cancer. The American Cancer Society (ACS) says women should begin yearly mammogram screening for breast cancer at age 45 if they are at average risk for breast cancer. The ACS also says those aged 40-44 have the option to start screening with a mammogram every year, and women age 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms.
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For screening purposes, a woman is considered to be at average risk if she doesn't have a personal history of breast cancer, a strong family history of breast cancer, a genetic mutation known to increase risk of breast cancer such as a BRCA gene mutation or a medical history including chest radiation therapy before the age of 30. Beyond genetics, family history and experience with radiation therapy, experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk for developing breast cancer, you should begin screening earlier.
In a previous interview with SurvivorNet, Dr. Connie Lehman, chief of the Breast Imaging Division at Massachusetts General Hospital, said people who hadn't reached menopause yet should prioritize getting a mammogram every year.
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"We know that cancers grow more rapidly in our younger patients, and having that annual mammogram can be lifesaving," Dr. Lehman said. "After menopause, it may be perfectly acceptable to reduce that frequency to every two years. But what I'm most concerned about is the women who haven't been in for a mammogram for two, three or four years, those women that have never had a mammogram. We all agree regular screening mammography saves lives."
It's also important to be on top of self breast exams. If you ever feel a lump in your breast, you should be vigilant and speak with your doctor right away. Voicing your concerns as soon as you have them can lead to earlier cancer detection which, in turn, can lead to better outcomes.
Understanding Your Risk
The risk of developing breast cancer varies greatly from person to person, so it's important to discuss your specific risk level with your doctor. That being said, there are some important risk factors to keep in mind.
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In a previous interview with SurvivorNet, Dr. Comen laid out several risk factors for breast cancer including:
- Being a woman: Women are at a higher risk for breast cancer, though men can get the disease too.
- Age: "Breast cancer becomes increasingly more common as women age," Dr. Comen said.
- Family history: "Some people think that breast cancer is only inherited through genes on the mom's side,' Dr. Comen said. "But it can also be related to genetic mutations that could be found on the father's side."
- Having had a prior biopsy on an abnormal area: "There are different markers, that if a woman has had a biopsy, it's important that she talk to her doctor about whether those markers are lending themselves to an increased risk of breast cancer," Dr. Comen said. If you've had a biopsy that indicated atypical hyperplasia, for example, you are at an increased risk of breast cancer. Atypical hyperplasia isn't cancer, but it is a precancerous condition that describes an accumulation of abnormal cells in the milk ducts and lobules of the breast.
- Radiation exposure: Cancer survivors who've had radiation to their chest are at an increased risk of breast cancer.
- Lifetime estrogen exposure: "About 2/3 of breast cancer are driven by the hormone estrogen," Dr. Comen said. "So, that means if a woman has had her period at an early age and started to go through puberty at an early age, at seven, eight, nine, and potentially a later age of menopause, means that her lifetime of having had menstrual periods and being exposed to higher levels of estrogen is higher, and therefore her risk of breast cancer is slightly higher."
- Not having a child before age 30 or never having children
- Obesity
- Drinking alcohol
- Lack of exercise: "While there's more research to be done in this area, it looks like if a woman is not exercising, she may also increase her risk for breast cancer," Dr. Comen said.
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